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Divisions of family practice support physicians in improving access to care for transgender patients

Transgender care has been identified as an emerging health care issue for family physicians and primary care providers. Recognizing the need to support physicians in the health care management of transgender patients in family practice, a number of divisions have undertaken projects to create sustainable solutions for ensuring transgender patients feel safe and confident in accessing care.

Through its ongoing work to attach patients to family doctors, Vancouver division became aware that there was only one GP in the region with the practice capacity and necessary skillset to take on transgender patients. To create a sustainable solution, the division looked at specific patient needs and the number of patients requiring care, and identified doctors who had come forward to help but who didn’t have the necessary skillset. The division then provided mentorship, training, networking, and resource opportunities for these GPs, all of which enabled five additional doctors to take on a cohort of transgender patients.

Fraser Northwest division’s Attachment Hub maintains a registry of patients needing attachment and GPs accepting patients, and operates a matching mechanism with referrals coming from various primary care, specialized, and public health sources. The division has encouraged physicians who are interested in accepting transgender patients to register with the Attachment Hub, and can connect physicians with a local mentor for transgender care.

The Abbotsford division found that members were experiencing difficulty in sourcing information and resources for transgender patients and providing timely, accessible care. The division received funding from the Shared Care Committee to develop a pathway of services and resources for the Fraser East region (Langley to Boston Bar) for transgender-specific health care. The Provider Pathway will support physicians and other health professionals by providing options for involvement depending on their level of interest and knowledge, ranging from making effective referrals for their patients to continued co-management of patients with specialists. The Patient Pathway will support patients and their families in navigating services and resources. The project’s steering committee comprises division members, specialists, Fraser Health, Abbotsford Youth Health Clinic, Trans Care BC, Vancouver Coastal Health, and community organizations. The care model will encompass services provided by GPs, gynecologists, psychiatrists, endocrinologists, and plastic surgeons, with the goal of developing a a pathway template that can be spread to other communities in the province.

Nanaimo, South Island, and Shuswap North Okanagan divisions have partnered with local stakeholders to create youth clinics at local high schools that provide safe, accessible, inclusive health care to students, including those who identify as LGBTQ. These clinics enable students to access care in a convenient, confidential environment without worrying about organizing transportation or needing to miss school to attend an appointment.

At Nanaimo division's John Barsby and Nanaimo District Secondary School Wellness Centres, care is provided to LGBTQ+ students by a team of physicians, nurses, and counsellors, encompassing all aspects of physical and mental health. There is signage posted throughout the wellness centres and school buildings advertising the centres' services as confidential, non-judgmental, and welcoming to LGBTQ+ clients. Students can access education materials at any time, and ​wellness centre staff have received extra training in providing health care to LGBTQ+ youth.

In addition to its school clinics, the South Island division has also opened a youth clinic at Ocean Pier Medical Centre in Sidney, which has become a known safe space for LGBTQ youth due to its non-binary setting.

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